Most Common Causes of Recurrent Pregnancy Loss

Miscarriages occur in 15-20% of all pregnancies and usually happen some time during the first 13 weeks. Experiencing multiple pregnancy losses can leave women concerned about their fertility and ability to have a healthy pregnancy and give birth. Many couples who have two pregnancy losses go on to carry a pregnancy to term and have a live birth. A fertility specialist can look into possible causes and discuss treatment options to increase your chances of conceiving.

What is recurrent pregnancy loss?

A small number of women experience recurrent pregnancy loss, which is defined as having two or more miscarriages. Chromosomal abnormalities are responsible for most miscarriages. This happens when an embryo receives an abnormal number of chromosomes during fertilization.

Each normal embryo has 46 chromosomes. The egg contributes 23 chromosomes and the sperm contributes the other 23 chromosomes. Sometimes pregnancy loss occurs when an embryo receives more or fewer than 46 chromosomes. There usually isn’t a medical cause. An embryo receiving an abnormal number of chromosomes typically happens by chance. However, older reproductive age is a risk factor.

Pregnancy loss is more likely to happen early on, during the first trimester, but some women experience recurrent late pregnancy loss. Various issues can cause recurrent late miscarriages, including uterine abnormalities and problems with the cervix.

Investigating recurrent pregnancy loss

Board-certified OB/GYN Dr. Richard Bardowell encourages couples who have had two or more miscarriages to have a comprehensive evaluation. Dr. Bardowell performs a range of tests on the mother and father to help determine a cause for recurrent pregnancy loss. The tests may include:

Common causes of recurrent pregnancy loss

Sometimes an exact cause of recurrent pregnancy loss isn’t found, and couples go on to have a successful pregnancy, with and without fertility assistance. When there is a cause found, it’s often one of the few common causes for recurrent pregnancy loss. Here are four of the most common causes.

Hormonal abnormalities

Abnormal hormone levels can cause recurrent pregnancy loss. Problems with thyroid, adrenal, and reproductive hormones can contribute to multiple miscarriages due to hormonal imbalance. Elevated prolactin levels can prevent the uterine lining from developing normally, and elevated testosterone in women with polycystic ovary syndrome can lead to problems getting and staying pregnant.

Cervical issues

The cervix must remain closed as the developing fetus grows. Cervical insufficiency, also known as “incompetent cervix,” occurs when weak cervical tissue contributes to the loss of pregnancy. In women with cervical insufficiency, instead of remaining closed until it’s time to give birth, the cervix opens too early.

Structural issues

Problems with the shape of the uterus can cause repeat pregnancy loss. Once an egg is fertilized, it travels and attaches to the uterus in a process known as implantation. Structural abnormalities can interfere with the ability of a fertilized egg to remain attached, resulting in pregnancy loss.

Other problems, such as uterine fibroids can cause poor implantation and result in pregnancy loss.

Autoimmune disorders

Problems with the immune system can cause miscarriages. Dr. Bardowell can perform blood tests to determine whether you have antibodies present in your blood that would indicate an immune-related issue.

Having an existing autoimmune disorder such as lupus makes you more likely to have antibodies that may cause pregnancy loss.

Treating recurrent pregnancy loss

Treatment for recurrent pregnancy loss depends on the result of a thorough evaluation. In vitro fertilization is one possible treatment. This involves combining an egg and sperm outside of the body and placing the embryo in the uterus after it forms.

In cases of structural abnormalities, minor surgery can often correct the problem. Correcting hormone imbalance can improve the chances of conceiving when hormonal problems are an underlying feature.

As an OB/GYN and fertility specialist, Dr. Bardowell is dedicated to helping couples identify possible causes of fertility problems and understand available treatment options. To learn more call 818-296-0925 to schedule a visit with Dr. Bardowell at our Burbank, California, clinic.

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